The childbearing center: an alternative birth setting

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Increasing trend of home deliveries noted.
• Need for a safe alternative to unattended home births.
• Limited options for low-risk obstetric care outside traditional hospital settings.

Purpose of the Study:

• To evaluate the safety and efficacy of an out-of-hospital birth unit.
• To provide an alternative to home delivery for low-risk women.
• To assess the feasibility of nurse-midwife led care in an out-of-hospital setting.

Main Methods:

• Establishment of an out-of-hospital unit in New York City in 1975.
• Care provided by a multidisciplinary team: nurse-midwives, obstetricians, pediatricians.
• Rigorous initial and ongoing screening of pregnant women for low medical risk.
• Established protocol for transfer to hospital services when necessary.
• Management of 244 births over 31 months.

Main Results:

• Successfully managed 244 births in the out-of-hospital unit.
• No life-threatening emergencies occurred during the study period.
• Demonstrated a safe environment for low-risk obstetric care.
• High level of patient screening and appropriate medical support.

Conclusions:

• Out-of-hospital birth units can safely provide care for low-risk obstetric populations.
• This model offers a viable alternative to home delivery.
• Multidisciplinary team approach ensures patient safety and well-being.